This procedure treats pancreatic cancer
“The Whipple” is a surgical procedure that removes the head of the pancreas, the first part of the intestine, called the duodenum, and the bile duct. It’s used to treat cancers that arise in those areas and is named after the surgeon Allen Oldfather Whipple.
Surgeons may also have to work on nearby blood vessels or the gallbladder, explains Mashaal Dhir, MD, chief of hepatobiliary and pancreatic surgery at Upstate.
“It is one of the most challenging procedures that we do because the pancreas is in general wrapped around two major blood vessels, SMA (superior mesenteric artery) and SMV, (superior mesenteric vein,)” he explains. “That’s why we encourage patients to have surgery in high-volume centers, and Upstate is one of the high-volume centers. That means we do this a lot. We do it well. And we monitor our outcomes.”
When pancreatic cancers are detected early, this procedure is potentially curative. Patients may spend a week in the hospital, and full recovery may take six to eight weeks, sometimes up to 12 weeks. They undergo repeated imaging scans every three months for the first three years after surgery, and then every six months from years three to five.
The surgery can be done as an open procedure through a large midline incision and generally takes about six to eight hours.
It can also be done robotically, through multiple small (quarter-sized) incisions on the belly. When a robot is used, the operation may take eight to 12 hours “because we have to work under magnification,” he says. “It’s more methodical, in a way, that we have to make finer movements because we are in a limited space. We have to blow up the belly with the gas, create the space and work around the blood vessels.”
Most patients prefer the robotic procedure because recovery is generally quicker and involves less pain. But not all patients have a choice. To qualify for robotic, the tumor must be smaller and located away from the blood vessels.
Hear Dhir describe the Whipple procedure in more detail on this episode of “The Informed Patient” podcast.
This article appears in the Winter 2025 issue of Cancer Care magazine.
